Facial Bones, Orbit, Sinuses, Nasal Bones Flashcards

1
Q

Label 1-6

A
  1. Left nasal bone
  2. Left lacrimal
  3. Left zygoma
  4. Left inferior nasal concha
  5. Left maxilla
  6. Mandible
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2
Q

What are the routine veiws for the facial bones?

A
  1. Lateral
  2. Waters
  3. Caldwell
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3
Q

Why is it better to image facial bones erect as opposed to recumbant?

A
  1. Air-fluid levels shown
  2. Easier for hypersthenic patients and/or patients with facial injuries
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4
Q

What anatomy should be superimposed in a lateral facial bones?

A
  1. Superimposed orbital roofs/plates
  2. Superimposed mandibular rami
  3. Superimposed zygmatic process of the maxilla
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5
Q

Where should the zygomatic bones be in a lateral facial bone image?

A

Zygomatic bones in center of radiograph

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6
Q

How can you acess for rotation on a lateral facial bone image?

A

Can tell rotation based on the zygomatic processes

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7
Q

What side is demonstrated in a lateral facial bones position?

A

Demonstrates side closest to IR

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8
Q

What projection is this?

A

Lateral Facial Bones

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9
Q

When placing the MML ⊥ to IR, at what angle is the OML from the IR?

A

OML 37° from IR

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10
Q

How do you acess for rotation on a Waters (Parietoacanthial) position for the facial bones?

A

Look at the zygomatic arches

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11
Q

What projection is this?

A

Waters (Parietoacanthial) position for the facial bones

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12
Q

When would the Acanthioparietal (Reverse Waters) method be used?

A

Used in a trauma situation, where you wouldn’t want to put the chin against the IR

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13
Q

What projection is this?

A

PA caldwell facial bones

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14
Q

Label 1-3

A
  1. Frontal orbital plate
  2. Zygoma
  3. Maxilla
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15
Q

What are the 3 main bones of the orbits that are being examined during an examination of the orbits?

A
  1. Frontal orbital plate
  2. Zygoma
  3. Maxilla
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16
Q

What are the reasons that we would be imaging the orbits?

A
  1. Foreign Body (Pre MRI; to rule out metal pieces)
  2. Pathology
  3. Fracture
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17
Q

What are the 3 main types of orbital fractures?

A
  1. Blowout fracture
  2. Tripod fracture
  3. Le Forte fracture
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18
Q

What type of orbital fracture is being shown here?

A

Le Forte fracture

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19
Q

What type of fracture is being shown here? What sign indicates that this fracture is present?

A

-Blowout fracture
-Teardrop sign

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20
Q

What patient preperation needs to be made prior to imaging the orbits for foreign bodies?

A
  1. Clean IR (also the IP if CR) and bucky/table top prior to imaging
  2. Patient history regarding possible foreign bodies in the eye
  3. Clean the outside of the outright bucky and the IR; CR we clean the plate, bucky and IP plate
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21
Q

What patient preparation needs to be made prior to imaging the cranium?

A
  1. Clean table top/bucky
  2. Remove any artifacts – dental appliances, wigs, hair pins, braids, jewelry, etc.
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22
Q

What are the routine views for the orbits?

A
  1. Lateral
  2. Modified Caldwell OR Modified Waters
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23
Q

What side is being demonstrated in a lateral orbit projection?

A

Side closest to the IR

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24
Q

Where should the orbits be in a lateral orbit projection?

A

Orbits in center of radiograph

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25
Q

What projection is this?

A

Lateral orbits

26
Q

Why should the patient focus on a spot and not move eyes during the exposure of thier orbits?

A

Since small particles may not be visualized since they may be blurred out

27
Q

Where should the petrous ridges be in a PA Axial – Modified Caldwell for the orbits?

A

Petrous ridges are seen below the inferior margin of the orbits

28
Q

What is the ideal projection to demonstrate possible orbital fractures and foreign bodies in the eye

A

Modified Parietoacanthial (Modified Waters or ‘Shallow Waters)

29
Q

What projection of the orbits is this?

A

Modified Parietoacanthial (Modified Waters or ‘Shallow Waters)

30
Q

What is the best projection to demonstrate blowout fractures?

A

Modified Parietoacanthial (Modified Waters or ‘Shallow Waters)

31
Q

Where should the petrous ridges be in a Modified Parietoacanthial (Modified Waters or ‘Shallow Waters)

A

Petrous ridges projected in lower ⅓ of maxillary sinuses

32
Q

Label 1-5

A
  1. Intersinus septum
  2. Sphenoidal sinus
  3. Maxillary sinus
  4. Frontal sinus
  5. Ethmoidal sinus
33
Q

What are the 4 essential sinus projections?

A
  1. Lateral
  2. Caldwell - Posteroanterior (PA) axial
  3. Open Mouth Waters -Parietoacanthial
  4. SMV - Submentovertical
34
Q

TF

Erect imaging is essential for sinus imaging. Why or why not?

A

True; necessary to demonstrate fluid levels

35
Q

T/F

We may lower the kVp technique for the sinuses from skull imaging. Why or why not?

A

True; good brightness and contrast are vital to demonstrate pathology

36
Q

What does the Lateral Projection of the sinuses demonstrate?

A
  1. Demos all 4 sinuses superimposed
  2. Anteroposterior (AP) and superoinferior dimensions of paranasal sinuses
  3. Thickness of frontal bone
37
Q

Which sinus is demonstrated the best in a lateral sinus projection?

A

The sphenoidal sinus

38
Q

What side is demonstrated in a lateral sinus projection?

A

Side closest to the IR

39
Q

What anatomy needs to be superimposed for a lateral sinus projection?

A
  1. Superimposed orbital roofs/plates
  2. Superimposed mandibular rami
  3. Superimposed zygomatic process of the maxilla
  4. Superimposed sella turcica
40
Q

What projection is being shown here?

A

Lateral sinus

41
Q

T/F

The frontonasal suture is above the frontal sinuses

A

False; Frontal sinuses above frontonasal suture

42
Q

What should be seen in a Caldwell Method of the sinuses?

A
  1. Anterior ethmoid air cells
  2. Sphenoid sinuses seen through nasal fossa below or between ethmoids
  3. Anterior ethmoidal air cells above petrous ridges
43
Q

Where should the petrous ridges be in a Caldwell method of the sinuses?

A

Petrous pyramids in lower third of orbits

44
Q

What method of the sinuses is being shown here?

A

Caldwell method of the sinuses

45
Q

Where should the petrous ridges be in a Parietoacanthial Projection (Open-Mouth Waters) of the sinuses?

A

Petrous pyramids lying inferior to maxillary floor

46
Q

What should be seen in a Parietoacanthial Projection (Open-Mouth Waters) of the sinuses?

A
  1. Sphenoid sinuses through open mouth
  2. Maxillary sinuses
  3. Clearly visible air-fluid levels, if present
47
Q

What projection is being shown here?

A

Parietoacanthial Projection (Open-Mouth Waters) of the sinuses

48
Q

What projection is being shown here?

A

Parietoacanthial Projection (Open-Mouth Waters) of the sinuses

49
Q

T/F

If a patient is unable to extend thier neck for the SMV, we can angle the tube to compensate.

A

False; Cannot angle the tube if the patient is unable to have the IOML perpendicular to the IR

50
Q

What should be seen in a SMV Projection of the sinuses?

A
  1. Sphenoid and ethmoid sinuses
  2. Mandible- superimposing the frontal bone
  3. Bony nasal septum
  4. Clearly visible air-fluid levels, if present
51
Q

What should be anterior to the petrous ridges in a SMV of the sinuses?

A

Mandibular condyles anterior to petrous pyramids

52
Q

What indicates that the IOML is parallel to the IR for the SMV of the sinuses?

(full proper extension)

A

Anterior frontal bone superimposed by mental protuberance

53
Q

How can you acess for tilt in an SMV of the sinuses?

A

If there is equal distance from lateral border of skull to mandibular condyles on both sides

54
Q

What projection is being shown here?

A

SMV of the sinuses

55
Q

What are the routine views of the nasal bones?

A
  1. Lateral
  2. Parietoacanthial (Waters)
56
Q

What should be seen on a lateral nasal bone projection?

A
  1. Bilateral Nasal bones centered
  2. No rotation
  3. Optimal exposure factors
  4. Tight collimation
57
Q

What projection is being shown here?

A

Lateral nasal bone

58
Q

Where should the petrous ridges be in a Nasal Bones – Waters projection?

A

Petrous ridges projected below maxillary sinuses

59
Q

What is the best projection to demonstrate lateral deviation of nasal septum

A

Nasal Bones – Waters projection

60
Q

What projection of the nasal bones is being shown here?

A

Nasal Bones – Waters projection

61
Q

Where should the petrous ridges be for a Waters (Parietoacanthial) position of the facial bones?

A

Petrous ridges below maxillary sinuses

62
Q

Where should the petrous ridges be for an Acanthioparietal (Reverse Waters) method?

A

Petrous ridges projected into lower ⅓ of orbits